Effect of dexmedetomidine infusion on N-terminal pro-B-type natriuretic peptide level in patients with femoral shaft fractures under general anesthesia

Authors

DOI:

https://doi.org/10.3329/bjp.v11i4.27620

Keywords:

Clinical trial, Dexmedetomidine, Femoral shaft fracture, General anesthesia, N-terminal pro-B-type natriuretic peptide

Abstract

This study was performed to assess the effect of dexmedetomidine on the level of N-terminal proB-type natriuretic peptide (NT-pro-BNP) in patients undergoing major orthopedic surgery. Patients undergoing general anesthesia for femoral shaft fracture surgery were randomly assigned to either 0.5 µg/kg/hour dexmedetomidine or normal saline. Changes in levels of NT-pro-BNP and hemodynamic parameters were compared. Data of 46 patients were analyzed and it was found that the change in NT-pro-BNP levels in the dexmedetomidine group was significantly less than the control group (p = 0.001). In addition, bleeding, changes in systolic and diastolic blood pressure in dexmedetomidine group was significantly less than the control group (p?0.001). It is likely that dexmedetomidine infusion can reduce the rise of NTpro-BNP level and therefore is associated with better cardiac outcome. In addition, dexmedetomidine infusion can achieve hemodynamic stability in femoral shaft fracture under general anesthesia.

Downloads

Download data is not yet available.
Abstract
1237
Download
766 Read
665

References

Betti I, Castelli G, Barchielli A, Beligni C, Boscherini V, De Luca L, Messeri G, Gheorghiade M, Maisel A, Zuppiroli A. The role of N-terminal PRO-brain natriuretic peptide and echocardiography for screening asymptomatic left ventricular dysfunction in a population at high risk for heart failure. The PROBE-HF study. J Card Fail. 2009; 15: 377-84.

Biccard B, Goga S, De Beurs J. Dexmedetomidine and cardiac protection for non?cardiac surgery: A meta?analysis of randomised controlled trials. Anaesthesia 2008; 63: 4-14.

Chong CP, Ryan JE, van Gaal WJ, Lam QT, Sinnappu RN, Burrell LM, Savige J, Lim WK. Usefulness of N-terminal probrain natriuretic peptide to predict postoperative cardiac complications and long-term mortality after emergency lower limb orthopedic surgery. Am J Cardiol. 2010; 106: 865-72.

Ellis JE, Drijvers G, Pedlow S, Laff SP, Sorrentino MJ, Foss JF, Shah M, Busse JR, Mantha S, McKinsey JF, et al. Premedication with oral and transdermal clonidine provides safe and efficacious postoperative sympatholysis. Anesth Analg. 1994; 79: 1133-40.

Ibraheim OA, Abdulmonem A, Baaj J, Zahrani T, Arlet V. Esmolol versus dexmedetomidine in scoliosis surgery: Study on intraoperative blood loss and hemodynamic changes. Middle East J Anesthesiol. 2013; 22: 27-33.

Ji F, Li Z, Nguyen H, Young N, Shi P, Fleming N, Liu H. Perioperative dexmedetomidine improves outcomes of cardiac surgery. Circulation 2013; 112: 000936.

Khan Z, Ferguson C, Jones R. Alpha?2 and imidazoline receptor agonists their pharmacology and therapeutic role. Anaesthesia 1999; 54: 146-65.

Mariappan R, Ashokkumar H, Kuppuswamy B. Comparing the effects of oral clonidine premedication with intraoperative dexmedetomidine infusion on anesthetic requirement and recovery from anesthesia in patients undergoing major spine surgery. J Neurosurg Anesthesiol. 2014; 26: 192-97.

Mizrak A, Karatas E, Saruhan R, Kara F, Oner U, Saricicek V, Baysal E. Does dexmedetomidine affect intraoperative blood loss and clotting tests in pediatric adenotonsillectomy patients? J Surg Res. 2013; 179: 94-98.

Moher D, Hopewell S, Schulz KF, Montori V, Gotzsche PC, Devereaux PJ, Elbourne D, Egger M, Altman DG. CONSORT 2010 explanation and elaboration: Updated guidelines for reporting parallel group randomised trials. J Clin Epidemiol. 2010; 63: e1-37.

Muzi M, Goff DR, Kampine JP, Roerig DL, Ebert TJ. Clonidine reduces sympathetic activity but maintains baroreflex responses in normotensive humans. Anesthesiology 1992; 77: 864-71.

Ren J, Zhang H, Huang L, Liu Y, Liu F, Dong Z. Protective effect of dexmedetomidine in coronary artery bypass grafting surgery. Exp Ther Med. 2013; 6: 497-502.

Shin HW, Yoo HN, Kim DH, Lee H, Shin HJ, Lee HW. Preanesthetic dexmedetomidine 1 µg/kg single infusion is a simple, easy, and economic adjuvant for general anesthesia. Korean J Anesthesiol. 2013; 65: 114-20.

Tepper D, Harris S, Ip R. The role of N?terminal pro?brain natriuretic peptide and echocardiography for screening asymptomatic left ventricular dysfunction in a population at high-risk for heart failure: The PROBE-HF Study. Congestive Heart Failure. 2009; 15: 296.

Vetrugno L, Langiano N, Gisonni R, Rizzardo A, Venchiarutti PE, Divella M, Della Rocca G. Prediction of early postoperative major cardiac events after elective orthopedic surgery: The role of B-type natriuretic peptide, the revised cardiac risk index, and ASA class. BMC Anesthesiol. 2014; 14: 1.

Published

2016-10-01

How to Cite

Mirkheshti, A., E. Memary, H. Shafiee, and M. Dahi. “Effect of Dexmedetomidine Infusion on N-Terminal Pro-B-Type Natriuretic Peptide Level in Patients With Femoral Shaft Fractures under General Anesthesia”. Bangladesh Journal of Pharmacology, vol. 11, no. 4, Oct. 2016, pp. 765-70, doi:10.3329/bjp.v11i4.27620.

Issue

Section

Clinical Trial